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Assessment of Right Ventricular Function in Patients with Chronic Obstructive Pulmonary Disease Using Echocardiographic Tei Index (만성 폐쇄성 폐질환 환자에서 Tei 지수를 이용한 우심실기능 평가)

  • Oh, Yoon-Jung;Shin, Joon-Han;Kim, Deog-Ki;Choi, Young-Hwa;Park, Kwang-Joo;Hwang, Sung-Chul;Lee, Yi-Hyeong
    • Tuberculosis and Respiratory Diseases
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    • v.50 no.3
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    • pp.343-352
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    • 2001
  • Background : Advanced chronic obstructive pulmonary disease is characterized by progressive pulmonary hypertension leading to right heart dysfunction, which plays a Important role in clinical evaluation but remains difficult and challenging to quantify. The noninvasive doppler echocardiographic value referred to as the Tei index has been suggested as a simple, reproducible and reliable parameter of the right ventricular function. The purpose of this was to assess the right ventricular function in patients with chronic obstructive pulmonary disease using the Tei index and to evaluate its relationship with the pulmonary functional status. Methods : The study population comprised of 26 patients with chronic obstructive pulmonary disease and 10 normal control subjects. The Tei index was obtained by dividing the sum of the isovolumetric contraction and the relaxation times by the ejection time using a pulsed-wave doppler. It was compared with the other available Doppler echocardiographic parameters of systolic or diastolic function and with the pulmonary function of the patients. Results : The Tei indices of the patients with COPD were significantly higher than those of normal subjects($0.45{\pm}0.17$ vs. $0.27{\pm}0.03$, p<0.01). The isovolumetric contraction time/ejection time($0.32{\pm}0.08$ vs. $0.25{\pm}0.05$, p<0.05), the isovolumetric relaxation time/ejection time($0.29{\pm}0.16$ vs. $0.15{\pm}0.08$, p<0.05)and the preejection period/ejection time ($0.46{\pm}0.10$ vs. $0.38{\pm}0.06$, p<0.05) were prolonged and the ejection time ($255.2{\pm}32.6$ vs. $314.2{\pm}16.5$ msec, p<0.05) was significantly shortened in patients with COPD compared to normal subjects. The tei indices were inversely correlated with the $FEV_1$ (r=-0.46, p<0.05) and were prolonged significantly in patients with a severe obstructive ventilatory dysfunction(less than 35% of predicted $FEV_1$) compared to those with a mild and moderate ventilatory dysfunction. The tei indices showed an inverse correlation to with the ejection time (r=-0.469), the isovolumetric contraction time/ejection time(r=0.453), the isovolumetric relaxation time/ejection time(r=0.896) and the preejection period/ejection time(r=0.480). Conclusion : The tei index appeared to be a useful noninvasive means of evaluating the right ventricular function. It revealed a significant correlation with the pulmonary function in patients with COPD.

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Prevalence of Orthostatic Dysregulation in Elementary School Students and Frequency of Individual Symptoms (학동기 아동의 Orthostatic Dysregulation의 유병률과 임상증상의 빈도에 대한 연구)

  • Yang, Eun Seok;Kim, Eun-Young;Moon, Kyoung-Rae;Park, Sang Kee;Park, Young Bong;Rho, Young Il
    • Clinical and Experimental Pediatrics
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    • v.48 no.2
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    • pp.138-142
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    • 2005
  • Purpose : The purpose of the present study was to access the prevalence of orthostatic dysregulation(OD) and the frequency of each category for major and minor criteria among elementary school students using the OD questionnaire. Methods : We carried out inquiry by questionnaire as to the frequency of OD among two elementary schools with 725 students, 10 to 12 years of age, residing in Gwangju, Korea. The questionnaire was made according to criteria proposed by the Japan OD Study Group. Results : Of the 725 students(male 390; female 335) questioned, the OD was found in 338 students (53.5 percent). Prevalence of OD in males(59.2 percent) was significantly higher than in females(46.8 percent)(P<0.05). Palpitation with slight exercise(95.9 percent) was the most frequent major symptom. Headaches(85.8 percent) were the most frequent minor symptom among cases of OD. Conclusion : The prevalence of OD in elementary school students in this study(53.5 percent) was higher than in other studies. Contrary to studies from other countries, the male to female ratio was reversed. Because the diagnostic criteria seem to be dependent on subjective reporting of the symptoms, a newer diagnostic system based on more objective findings should be established.

Treatment and Prognosis for an Esthesioneuroblastoma over a 20-Year Period: Impact of Treatment Era (감각신경모세포종의 20년에 걸친 치료와 예후 분석: 치료 시기에 따른 차이)

  • Song, Chang-Hoon;Kim, Il-Han;Wu, Hong-Gyun;Kim, Dong-Wan;Rhee, Chae-Seo
    • Radiation Oncology Journal
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    • v.27 no.4
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    • pp.189-193
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    • 2009
  • Purpose: To report on the changes in the patterns of care and survival over time for esthesioneuroblastoma. Materials and Methods: We retrospectively analyzed 42 previously untreated and histologically confirmed esthesioneuroblastoma patients seen between March 1989 and June 2007. According to Kadish's classification, 3 patients (7%) were stage A, 6 (14%) at stage B, and 33 (79%) at stage C. Of the 33 Kadish C patients, 19 and 14 patients were treated from 1989 through 2000 and from 2001 through 2007, respectively. Treatment included surgical resection, radiotherapy, chemotherapy, or a combination of these methods. Chemotherapy was administered to 8 of 19 patients (42%) seen from 1989 through 2000, whereas all of the 14 patients seen from 2001 through 2007 received chemotherapy (p<0.001). No patient was treated by three-dimensional conformal radiotherapy (3D-CRT) from 1989 through 2000, however 8 of 14 patients (67%) seen from 2001 through 2007 underwent 3D-CRT (p<0.001). The median follow-up time for surviving patients was 6.5 years (range, 2.2~15.8 years). Results: The 5-year overall survival (OS) and progression-free survival (PFS) rates for the entire cohort were 53% and 39%, respectively. The 5-year OS was 100% for Kadish stages A or B and 39% for stage C (p=0.007). For patients with stage C disease who were treated from 1989 to 2000 and from 2001 to 2007, the 5-year OS rate was 26% and 59% (p=0.029), respectively and the corresponding 5-year PFS rate was 16% and 46% (p=0.001), respectively. Intraorbital extension and treatment era (1989~2000 vs. 2001~2007) were found as independent factors for OS and PFS in a multivariate analyses. Conclusion: The results of this study suggest that treatment era, which features a distinction in treatment modality and technique with the introduction of 3D-CRT, may be the cause of improved OS and PFS in Kadish stage C patients. To achieve better outcomes for patients with Kadish stage C, combined chemoradiotherapy, especially 3D-CRT, is recommended in addition to surgery.

The Results of Radiotherapy in Locally Advanced, Unresectable Pancreatic Cancer (절제 불가능한 국소 진행된 췌장암에서 방사선치료의 결과분석)

  • Jang, Hyun-Soo;Kang, Seung-Hee;Kim, Sang-Won;Chun, Mi-Son;Jo, Sun-Mi;Lim, Jun-Chul;Oh, Young-Taek;Kang, Seok-Yun
    • Radiation Oncology Journal
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    • v.27 no.3
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    • pp.145-152
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    • 2009
  • Purpose: We retrospectively studied the outcomes and prognostic factors of patients with locally advanced, unresectable pancreatic cancer who were treated with concurrent chemoradiotherapy (CCRT) or radiotherapy only. Materials and Methods: Fifty-one patients with locally advanced, unresectable pancreatic cancer (stage IIA~III) who recevied radiotherapy ($\geq$30 Gy) between January 1994 and August 2008 were reviewed retrospectively. The median radiation dose was 39 Gy. Chemotherapy consisted of gemcitabine, cisplatin, or 5-FU alone or in various combinations, and was administered concurrently with radiotherapy in 38 patients. Results: The follow-up period ranged from 2~40 months (median, 8 months). The median survival, and the 1-and 2-year overall survival (OS) rates were 7 months, 15.7%, and 5.9%, respectively. Based on univariate analysis, the baseline CA19-9, performance status, and chemotherapy regimen were significant prognostic factors. The median survival was 8 months for CCRT, and 6 months for radiotherapy alone. The patients treated with gemcitabine-containing regimens had longer survival (median, 10 months) than the patients treated with radiotherapy alone (p=0.027). Twenty-three patients were available to evaluate the patterns of failure. Distant metastases (DM) occured in 18 patients and regional recurrences were demonstrated in 4 patients. Local progression developed in 14 patients. We analyzed the association between the time-to-DM and the baseline CA19-9 levels for 18 evaluable patients. The median time-to-DM was 20 months for patients with normal baseline CA19-9 levels and 2 months for patients with baseline CA19-9 levels $\geq$200 U/ml. Conclusion: CCRT with gemcitabine-based regimens was effective in improving OS in patients with locally advanced, unresectable pancreatic cancer. We suggest that the baseline CA19-9 level is valuable in determining the treatment strategy for patients with locally advanced, unresectable pancreatic cancer.

Modelling of Fault Deformation Induced by Fluid Injection using Hydro-Mechanical Coupled 3D Particle Flow Code: DECOVALEX-2019 Task B (수리역학적연계 3차원 입자유동코드를 사용한 유체주입에 의한 단층변형 모델링: DECOVALEX-2019 Task B)

  • Yoon, Jeoung Seok;Zhou, Jian
    • Tunnel and Underground Space
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    • v.30 no.4
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    • pp.320-334
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    • 2020
  • This study presents an application of hydro-mechanical coupled Particle Flow Code 3D (PFC3D) to simulation of fluid injection induced fault slip experiment conducted in Mont Terri Switzerland as a part of a task in an international research project DECOVALEX-2019. We also aimed as identifying the current limitations of the modelling method and issues for further development. A fluid flow algorithm was developed and implemented in a 3D pore-pipe network model in a 3D bonded particle assembly using PFC3D v5, and was applied to Mont Terri Step 2 minor fault activation experiment. The simulated results showed that the injected fluid migrates through the permeable fault zone and induces fault deformation, demonstrating a full hydro-mechanical coupled behavior. The simulated results were, however, partially matching with the field measurement. The simulated pressure build-up at the monitoring location showed linear and progressive increase, whereas the field measurement showed an abrupt increase associated with the fault slip We conclude that such difference between the modelling and the field test is due to the structure of the fault in the model which was represented as a combination of damage zone and core fractures. The modelled fault is likely larger in size than the real fault in Mont Terri site. Therefore, the modelled fault allows several path ways of fluid flow from the injection location to the pressure monitoring location, leading to smooth pressure build-up at the monitoring location while the injection pressure increases, and an early start of pressure decay even before the injection pressure reaches the maximum. We also conclude that the clay filling in the real fault could have acted as a fluid barrier which may have resulted in formation of fluid over-pressurization locally in the fault. Unlike the pressure result, the simulated fault deformations were matching with the field measurements. A better way of modelling a heterogeneous clay-filled fault structure with a narrow zone should be studied further to improve the applicability of the modelling method to fluid injection induced fault activation.

Association of the CYP1B1 Gene Polymorphism with the Risk of Advanced Endometriosis in Korean Women (한국 여성에서 중증자궁내막증과 CYP1B1 유전자 다형성과의 관련성에 관한 연구)

  • Cho, Yeon Jean;Hur, Sung-Eun;Lee, Ji Young;Song, In Ok;Koong, Mi Kyoung;Moon, Hye Sung;Chung, Hye-Won
    • Clinical and Experimental Reproductive Medicine
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    • v.33 no.2
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    • pp.85-95
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    • 2006
  • Objective: To investigate whether polymorphisms of gene encoding CYP1B1 is associated with the risk of endometriosis in Korean women. Methods: We investigated 199 patients with histopathologically confirmed endometriosis rAFS stage III/IV and 183 control group women who were surgically proven to have no endometriosis. The genetic distribution of four different CYP1B1 polymorphisms at $G^{119}-T$, $G^{432}-C$, $T^{449}-C$, and $A^{453}-G$ were analyzed by polymerase chain reaction(PCR) and restriction fragment length polymorphism of PCR products. Results: We found no overall association between each individual CYP1B1 genotype and the risk of endometriosis. The odds ratio of genotype GG/GC+GG/TC+TT/AA compared to GG/CC/CC/AA(reference) was calculated as 2.06 with a 95% confidence interval of 1.003~4.216. Conclusion: This results suggest that CYP1B1 genetic polymorphism may be associated with development of endometriosis in Korean women.

A Comparative Study of Effect of Secondary Anti-tuberculosis Drugs in the Retreatment of Pulmonary Tuberculosis (폐결핵 재치료에서 이차항결핵제 복합처방의 효과에 관한 비교 연구)

  • Ha, Hyun-Cheol;Kwon, Eun-Soo;Choi, In-Hwan;Hwang, Su-Hee;Park, Seung-Kyu;Song, Sun-Dae
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.6
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    • pp.1154-1166
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    • 1998
  • Background : In the management of patients whose primary chemotherapy has failed, careful assessment is essential. It is important to find out as accurate a chemotherapy history as possible. Preferably it should contain the drugs which has never used before. The purpose of present study is establishment of retreatment regimen for pulmonary tuberculosis. The present report concerns the results of retreatment of pulmonary tuberculosis patients treated at National Masan Tuberculosis Hospital. Methods : Retrospective cohort study was made of 104 drug-resistant pulmonary tuberculosis patients who were treated by five regimens between Jan. 1994 and Nov. 1996. All the patients taken medicine for second anti-tuberculosis regimens for the first time. We separated the patients by three groups(Group I ; OFX+PTA+CS+PAS+Aminoglycoside, Group II : PZA+PTA+CS+PAS+Aminoglycoside, Group III : PZA+OFX+PTA+PAS+Aminoglycoside). Results : The age distribution was most frequent in fourth decade(36patients, 34.6%) and the mean age was 42.6 year. The sex distribution was more frequent in the males(81 patients, 85.7%). There was 31 patients(29.8%) with combined diseaes, 18 patients with complication and 24 patients(27.9%) with family history. Primary chemotherapy regimens were HERZ(S or K) in 48 patients (46.2%), HER(S or K) in 41 patients(39.4%) and others in 15 patients(14.4%). Result of drug sensitivity test showed that the resistance to INH and RFP is in 68 patients(65.4%), RFP is 12 patients(11.5%), INH is in 3 patients(2.9%) and all sensitive to INH and RFP is 3 patients(2.9%). The clinical symptoms on admission were coughing(89.4%), sputum(69.2%), dyspnea on exertion(37.5%), weight loss(33.7%) blood tinged sputum(15.4%) and others. The extent of disease on the radiograph was far-advanced in 73 patients(70.2%), moderate in 28 patients(26.9%) and minimal in 3 patients(2.9%). The side effects for drugs were gastrointestinal troubles in 31 patients(29.8%), arthralgia in 22 patients(21.2%), skin rash in 12 patients(11.5%) and others. The negative conversion rate on sputum AFB smear was 85.6%(87.5% in Group I, 80.0% in Group II and 90.5% in Group III). The average negative conversion time on sputum was 4 month(4.0 month in Group I, 4.6 month in Group II and 3.0 month in Group III). Conclusion : In the retreatment of pulmonary tuberculosis, ofloxacin is useful drug for the patients who are not available to use PZA and combination of PZA and OFX can be use effectively substituting for CS.

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Measurement of Ventilatory Threshold in the Patients with Chronic Airway Obstruction (만성기도폐쇄를 보이는 환자에서 환기성역치 측정)

  • Lee, Kye-Young;Jee, Young-Koo;Kim, Keun-Yeol
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.2
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    • pp.309-320
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    • 1997
  • Background : There are many suggested methods for the indirect determination of anaerobic threshold(AT) using the changes of ventilatory parameters in response to ventilatory load accompanying the increase of blood lactic acid level during exercise and the threshold derived from them is called ventilatory threshold(VT). They include ventilatory equivalent method(VEM), End-tidal $PO_2$ method($PETO_2$). V-slope method(VSM), and respiratory quotient method(RQ). But in the patients with chronic airway obstruction(CAO), the AT determined by ventilatory methods may not reflect true AT because the patients with CAO show inadequate ventilatory response to the increase of blood lactic acid level during excercise. Methods : For the investigation of detection rate and reliability of above four VT determination methods in the patients with CAO, we performed the symptom-limited and maximal incremental exercise test in 17 patients with CAO and 12 normal controls. The incremental workload was 10 W /min in CAO group and 25 W/min in control group. The reliability of VT in each group was investigated by the calculation of Spearman correlation coefficient. Results : The detection rates of VT were 100% by RQ, 91.7% by both VEM and $POETO_2$, and 83.3% by VSM in normal control group, while 94.1% by RQ, 64.7% by VEM and $PETO_2$, and 83.3% by VSM in CAO group. Good correlations were noted among VEM, $POETO_2$, and VSM except RQ in normal control group. But there was no significant correlation except between VEM and $PETO_2$ in CAO group. Conclusions : RQ is very sensitive but crude and VEM is near similar to $PETO_2$. The clinical usefulness of VT determined by ventilatory method might be limited in patients with severe CAO.

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STANDARDIZATION OF WORD/NONWORD READING TEST AND LETTER-SYMBOL DISCRIMINATION TASK FOR THE DIAGNOSIS OF DEVELOPMENTAL READING DISABILITY (발달성 읽기 장애 진단을 위한 단어/비단어 읽기 검사와 글자기호감별검사의 표준화 연구)

  • Cho, Soo-Churl;Lee, Jung-Bun;Chungh, Dong-Seon;Shin, Sung-Woong
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.14 no.1
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    • pp.81-94
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    • 2003
  • Objectives:Developmental reading disorder is a condition which manifests significant developmenttal delay in reading ability or persistent errors. About 3-7% of school-age children have this condition. The purpose of the present study was to validate the diagnostic values of Word/Nonword Reading Test and Letter-Symbol Discrimination Task for the purpose of overcoming the caveats of Basic Learning Skills Test. Methods:Sixty-three reading-disordered patients(mean age 10.48 years old) and sex, age-matched 77 normal children(mean age 10.33 years old) were selected by clinical evaluation and DSM-IV criteria. Reading I and II of Basic Learning Skills Test, Word/Nonword Reading Test, and Letter-Symbol Discrimination Task were carried out to them. Word/Nonword Reading Test:One hundred usual highfrequency words and one hundred meaningless nonwords were presented to the subjects within 1.2 and 2.4 seconds, respectively. Through these results, automatized phonological processing ability and conscious letter-sound matching ability were estimated. Letter-Symbol Discrimination Task:mirror image letters which reading-disordered patients are apt to confuse were used. Reliability, concurrent validity, construct validity, and discriminant validity tests were conducted. Results:Word/Nonword Reading Test:the reliability(alpha) was 0.96, and concurrent validity with Basic Learning Skills test was 0.94. The patients with developmental reading disorders differed significantly from normal children in Word/Nonword Reading Test performances. Through discriminant analysis, 83.0% of original cases were correctly classified by this test. Letter-Symbol Discrimination Task:the reliability(alpha) was 0.86, and concurrent validity with Basic Learning Skills test was 0.86. There were significant differences in scores between the patients and normal children. Factor analysis revealed that this test were composed of saccadic mirror image processing, global accuracy, mirror image processing deficit, static image processing, global vigilance deficit, and inattention-impulsivity factors. By discriminant analysis, 87.3% of the patients and normal children were correctly classified. Conclusion:The patients with developmental reading disorders had deficits in automatized visuallexical route, morpheme-phoneme conversion mechanism, and visual information processing. These deficits were reliably and validly evaluated by Word/Nonword Reading Test and Letter-Symbol Discrimination Task.

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Change of Perception and New Methodology of Korean Cartoon Exhibition (한국만화전시의 인식변화와 새로운 방법론)

  • Kim, Jeung-Yeun
    • Cartoon and Animation Studies
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    • s.39
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    • pp.413-450
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    • 2015
  • Although cartoons have been recognized for their great potential and value, they have failed to bloom in Korea. This is because wrong perception and irregular distribution of cartoons have been repeated for the last several years. Presently, however, cartoons are escaping from chronic problems they have had for long and welcoming splendid chances now. From the mid- and late-1990's, there have been large-scale events having cartoons as their theme, and social recognition on cartoons is becoming more and more positive. Their contents are diversified, readers are increased, and they are escaping from stereotypes through harmony with other media. Lately, either large or small exhibitions for cartoons are being planned, and Korean cartoons are going overseas and producing exhibitions there. Particularly, visitors' appreciative eye is getting keener, and they begin to see them not as a genre underestimated as low culture like in the past but as a kind of art on which independent research is being actively conducted. One of the biggest factors that have allowed cartoons to be positioned as visual art is the form of exhibitions that combine them with other genres artistically. Especially the cartoon exhibitions being held these days are aggressively introducing various elements of the cartoon genre through the medium of exhibitions not just as a mere tool of seeing to help understand cartoon writers or works. The genre of cartoons is now regarded as an active subject that can reflect its own unique essence in this rapidly changing cultural environment and extend the range of it itself. The latest cartoon exhibitions are characterized by trans-genre and complex aspects in terms of their direction or organization according to the contents, space, or theme. This trend of cartoon exhibitions implies that they are subdividing, analyzing, and planning various factors not in a horizontal way that was centered around image as in the past. It means that cartoon exhibitions are evolving as a form of mobilizing, combining, and reproducing various methods. Although a number of cartoon exhibitions are being held with a variety of themes, there is still lack of research on cartoon exhibitions concerning their forms and contents. Therefore, this researcher sees cartoon exhibitions as a factor that allows cartoons to escape from negative recognition and examines various cartoon exhibitions, from Seoul International Cartoon Animation Festival to the ones that are recently held, to figure out the meaning of Korean cartoon exhibitions. Furthermore, this researcher will find out the factors of planning and popularity in international exhibitions or personal cartoon exhibitions being presently held and figure out new directions and potentials for Korean cartoon exhibitions based on that. To meet the needs of visitors whose expectations have become even higher, it is needed to try not just previous methods but experimental and original planning as well constantly. To realize that, it is necessary to keep providing a field of opportunity where cartoon works, cartoon writers, and visitors can communicate as in an exhibition. It is expected that this study will trigger research on cartoon exhibitions to be performed multilaterally and produce new discourse on cartoon exhibitions afterwards.